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These children also had detectable signs of lead poisoning. The line of gingival hyperpigmentation in the first patient has been described in occupationally lead exposed adults . He also had a “lead line” on long bone radiography. The width of the dense metaphysis has been reported to correlate with the length of the period of toxic exposure .

A 50 year-old woman presented to her primary care physician for evaluation of a 2 week history of right upper quadrant abdominal pain and weight loss. CT of the abdomen and pelvis revealed multifocal hepatic disease and a dominant 7 cm lesion in the right lobe of the liver (Figure 1). CT scans of chest and brain showed no evidence of extrahepatic disease.

We report case of a young man who came for a second opinion at our clinic for left scrotal swelling for which he was advised a left radical orchidectomy by another surgeon. Surgeons should be aware of this rare condition and must do a careful evaluation to prevent unnecessary removal of the testis.

The rash was described by dermatology as a confluent scaly red rash in the distribution of the radiation mask that resembled the patient's previous cutaneous skin rash from lupus but was not responsive to the topical steroid treatment. A shave biopsy of skin measuring 0.4 x 0.3 x 0.1 cm was taken. Histopathological findings of the specimen were described as spongiotic psoriasiform hyperplasia accompanied by superficial perivascular infiltrate of lymphocytes and eosinophils. Diagnosis from the pathology sample indicated allergic contact dermatitis.

The complications of the case described are significant and can have serious implications for altering the effectiveness of radiation therapy if the dermatitis is severe enough to prevent further treatment or if the typical radiation dermatitis is worsened. Consequences of missed or delayed radiation treatments are well documented and are shown to be associated with an increased risk of cancer recurrence .

We retrospectively reviewed the clinical records of patients presenting with a solitary pulmonary nodule (SPN) who had undergone CBCT-guided lesion localization with ICG in a HOR between July 2017 and May 2021. The study complied with the tenets of the Helsinki Declaration and was granted ethical approval by the Institutional Review Board (reference: CGMH-IRB 201600671A3). The need for patient consent was waived due to the study design.

We conducted a review of the literature to identify how previous cases of chest wall hematomas exterior to the endothoracic fascia following blunt trauma have been diagnosed and managed. We hypothesized that most cases were diagnosed by CTA of the chest and managed by surgical drainage similarly to our case.

The present study using a round endcap expandable cage on the vertebral ring apophysis improved the local kyphotic angle and increased intervertebral height. The coronal Cobb angle was not worse after surgery. There were no cases of cage subsidence of 5 mm or more and all patients achieved bone union.

Fifteen children were studied with intractable seizure other than spasm. The seizure was controlled in 13 cases by ACTH therapy but recurrence of seizures was observed in 6 of them within 3 months after stopping ACTH therapy (6). Successful use of ACTH was described in two patients with generalized epilepsy who had refractory to multiple AED (13).

This disorder has been initially reported by Longman et al. in a 17-year-old girl who displayed weakness some months after birth and manifested severe mental retardation. Failure of brain migration and white matter anomalies with abnormal electroretinogram were also reported. This anomaly may disclose some clinical features of MEB and/or WWS.

The position of two skin surface electrodes and the connection with the stimulator. A large cathodal electrode (2 × 3.5 in.) was placed on the front of the foot and a small anodal electrode (2 × 2 in.) was placed between the inner foot arch and the heel. A written consent was obtained from the patient for publication of the image in the journal

Photographs were taken at the first presentation with a lesion. Every lesion on the patient was photographed from the same distance with a case identification number while date was clearly visible in the image to be used for the assessment of clinical forms.

We present a patient with an anoxic event in the context of drug use who demonstrated clinical evidence of an anterograde amnesia for both explicit and implicit/procedural information. We will discuss the possible etiological factors in the production of the relatively unique bilateral hippocampal and bilateral basal ganglia lesions as well as the evidence of the neuroanatomical correlates with his amnesia.

The patient was first referred to our service in April 1998 (woman; age: 60 years; current age: 78 years). At that moment we diagnosed her with limited cutaneous SSc according to the following manifestations: Raynaud's phenomenon (RP); sclerodactyly; anti-nuclear antibodies (ANA) titre: 1 : 1280 with speckled pattern; anti-Ro: positive; anti-centromere: positive; and enlarged capillaries in nailfold capillaroscopy.

On November 2015 she came to our office after the sudden appearance of DU in her second distal interphalangeal joint (palmar) of the right hand and second distal phalanx of the left hand (dorsal) (Figure 1(a)). The laboratory tests also showed a hypertransaminasemia (aspartate aminotransferase (AST): 73 U/L; alanine transaminase (ALT): 90 U/L; alkaline phosphatase (ALP): 161 U/L; and gamma-glutamyl transferase (GGT): 208 U/L).

Our experience with toxicity associated with apatinib (Table 4) seemed to be more severe from that described in clinical trials . One patient had to stop using apatinib because of neuro-toxicity. Three patients had so serious anorexia and weight loss that they stopped using the agent. Nine of our patients had treatment-related pneumothorax and six patients had wound healing problems.

A) Model of chromosome 6 indicating the placement of the primer pairs in the PCR amplification of the GCNT2 region. Visualization (on a 1.5% agarose gel) of the amplification products from each primer pair with the DNA of B) an unaffected and C) affected member of PKCC215. Amplification of the genomic DNA of the affected individual was successful (produced specific PCR products) with the primer pairs indicated in green. Amplification of the affected individual’s DNA failed (non-specific or no PCR products) with the primer pairs indicated in red. Note: Asterisk indicates non-specific PCR products.

Three years and 5 months have elapsed without hernia recurrence or complications since the operation. This parastomal hernia repair using a composite mesh seems to be a useful treatment for incisional hernias developing after esophagectomy with antethoracic pedicled jejunal flap reconstruction.

None of the patients we treated experienced problems related to the implants over six months to three years (osseointegration failure or wound healing problems). All the patients in our series underwent one-stage surgery. Only one patient encountered a relatively exuberant scar in the area of surgical remnants removing. The complication was successfully treated with steroid local infiltration.

The patient was treated for four weeks with intravenous flucloxacillin and was discharged with an oral regime consisting of levofloxacin (500 mg/d) and rifampicin (450 mg twice daily) for another four weeks. One month after completion of the antibiotic therapy the patient was well with no signs of active infection or recurrence. A report was filed with the Federal Institute for Drugs and Medical Devices (BfArm).

All HPS patients received a 3-month course of antibiotic therapy which consisted of at minimum 2 week course of parenteral antibiotics based on culture results. Outpatient oral antibiotic treatment completed a 3 month course of antibiotics after normalization of serum C-reactive protein (CRP) levels and leukocyte counts. Patients who survived were followed-up for a minimum of 2 years.

Pictures taken during the surgical procedure. a Incision in the left hind limb. b Artery is fixed with a medial and lateral suture. c Catheter is inserted in the artery. d Catheter is secured with two sutures. Artery is closed with a third suture at the lateral side.

We report an uncommon case of an adult male from the Midwestern United States presenting with as acute pericarditis due to Histoplasma capsulatum infection. We reviewed the literature on H. capsulatum pericarditis and discussed the diagnosis and management of necrotizing granulomatous pericarditis due to H. capsulatum. We recommend that histoplasmosis infection be on the differential diagnoses in patients having acute pericarditis in endemic regions.

Endoscopic submucosal dissection (ESD) of a high-grade rectal dysplasia. a Endoscopic view of the lesion; b marker dots on the normal mucosa; c mucosal incision along the marker dots; d the artificial ulcer bed after ESD; e tissue specimens fixed to a wooden plate using thin needles; f endoscopic view of the scar during follow-up period

Fig 3 shows the results of a 33-year-old male subject under the following conditions: the head position was upright and tilted 50° to the right and left. We detected the blind spot rotation in the direction opposite to head tilting. All subjects showed the same tendency.

Initial computed tomography (CT) scan with measurements of the dimensions of the spinal cord length and diameter of the area of interest later for spinal cord balloon compression. The length of the spinal cord from thoracic (T) spinal cord level T11 to T13 is 4.51 cm. The diameter at T12 is 0.97 cm and at T13 0.94 cm

We report what is to the best of our knowledge the first published case of MCN-L with extrahepatic growth in Thailand. Our patient presented with ascending cholangitis at a local hospital and was then referred to our university teaching tertiary care hospital. We needed to perform multiple procedures for investigation and biliary drainage before arriving at a definitive diagnosis and treatment. A literature review on investigations and management of MCN-L is included.

Based on these we made a tentative diagnosis of bilateral lower limb deep venous thrombosis in early pregnancy with a possible pelvic vein thrombosis that was misdiagnosed for acute appendicitis. Our health facility was not equipped with the necessary tools and personnel to confirm our diagnosis and manage the patient. She was therefore referred to a tertiary care center about 40 km from our facility.

The patient was immediately started on low molecular weight heparin (LMWH) 80 mg subcutaneous route daily. After 5 days of treatment the patient’s symptoms had subsided and she was discharge and counter referred for continuation of care. We continued her daily LMWH injections and scheduled her for a repeat of the pelvic and lower limb ultrasound. Six weeks later there were no more echoes in the pelvic and lower limb veins (Fig. 2). She continued daily LMWH till 12 weeks postpartum.Fig. 2Echography showing no more echoic images inside the right common iliac vein

The case presented confirms that PVT has a similar presentation to and is often confounded with acute appendicitis. PVT should thus be considered in any pregnant woman presenting with unexplained lower abdominal pains with a clinical picture similar to that of acute appendicitis. Clinicians should have a high index of suspicion in order to make a proper and early diagnosis so as to optimize the prognosis.

Colour fundus photography (a). Whitish tumour with calcification at the centre in the upper temporal region of the left eye. Retinal greying with small crystalline deposits and impaired structure of the capillary network with small telangiectasias in temporal parafoveolar region of both eyes. All changes are better visible in red-free documentation of the fundus (b)

Examples of ultrasound cross-sections showing measurements of cross-sectional area of median nerve in arm. (A) Homogeneous enlargement was shown at sites A7–A10 of median nerve in a Charcot–Marie–Tooth type 1A patient. (B) Segmental enlargement was seen at sites A7–A10 of median nerve in a chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patient (type 3). (C) Mild nerve enlargement was shown at sites A7–A10 of median nerve in a CIDP patient (type 2).

Evaluation of the left fourth digit of the hand demonstrated a nail with excessive ridging and prominent subungual debris. There was neither elevation of the nail plate nor pigmentation of the proximal nail fold. There were no other dystrophic fingernails or toenails. The differential diagnosis included onychomycosis and trauma-induced nail dystrophy.

Nail clippings were obtained; periodic acid-Schiff staining demonstrated fungal hyphae within the nail plate (Figure 1). The diagnosis of onychomycosis was established and considered to be the cause of her nail dystrophy. She declined oral antifungal therapy.

A correlation of the clinical presentation and pathology findings established the diagnosis of a subungual amelanotic melanoma. The patient was referred to a surgical oncologist for further evaluation and management. Systemic work-up did not demonstrate metastatic disease. A sentinel lymph node biopsy from the left axilla was negative for melanoma. She subsequently underwent an amputation of the digit. She is currently disease-free and regularly receives total body skin checks and follow-up evaluations by the surgeon.

Direct examination of clinical samples was performed with KOH 10%. Cultures were performed on modified Sabouraud dextrose agar and mycobiotic agar at 25°C. Suspected Paracoccidioides cultures were subcultured in Fava-Netto agar at 37°C for dimorphism confirmation. Serology for PCM was performed using Ouchterlony double immunodiffusion (ID).

Direct smears were prepared from the edge of skin lesions on different parts of body by using vaccinostyle and were fixed with pure methanol. Samples were stained by Giemsa 10% and examined under a light microscope and amastigote forms of Leishmania species were observed and CL was confirmed (Figure 2).

a 28.12.2006: Parasagittal PD-sequence with open mouth in a patient with anterior disk dislocation without reposition and more severely impaired translation (condyle remains posterior to the articular eminence). b 14.10.2013: Parasagittal PD-sequence with open mouth 7 years later shows a faint pseudo-disk and range of mouth opening has slightly improved

We report a case of a patient who was found to have a right iliac fossa mass which was diagnosed as a localized collection of pus from a ruptured liver abscess which has been walled off. To our knowledge this is the first case ever reported of this kind. The case proves further the wide variety of clinical presentations of amoebic liver abscess and highlights that a high degree of clinical suspicion or vigilance is warranted in the diagnosis of this condition to prevent its potentially fatal complications.

His loose stools and right lower abdominal discomfort improved on the next day of aspiration. Fever defervescence was noted on the third day of admission and he was discharged on the 5th day with a course of oral metronidazole for a total duration of 14 days. He was given iodoquinol 650 mg eight hourly for 20 days to eradicate the intestinal colonization of the parasites. He made an uneventful recovery with complete resolution of the symptoms and the repeat ultrasound scan of the abdomen which was done after 2 months from admission confirmed complete resolution of both abscesses and RIF collection.

The postoperative period was uneventful. The patient was discharged on the 2nd postoperative day. She returned back to her normal daily activities and was advised to follow‐up after 4 weeks. Consent for publication of the report was obtained from the patient as well as from the institutional review board (IRB).

( A) Magnetic resonance imaging of an adult woman who has medulloblastoma in the brain and spine with leptomeningeal spread: ( a) axial T1 of the brain post-gadolinium contrast; ( b) coronal T1 of the brain post-gadolinium contrast; ( c) sagittal T1 of the cervical spine post-gadolinium contrast. ( B) Brain magnetic resonance imaging of pediatric medulloblastomas: ( a) sagittal post-gadolinium WNT tumor; ( b) axial T2 of a SHH tumor. Red arrows delineate the tumor/leptomeningeal disease.

The diffuse proliferative sclerosing pattern that was observed along with early crescent formation and the positive results for ANA and anti‐dsDNA antibodies confirmed the diagnosis of stage IV lupus nephritis according to Systemic Lupus Collaborating Clinics (SLICC) criteria. 6

Keystone flap closure of a melanoma excision defect on the left foot. The patient presented with a T1a lesion on the dorsum of her left foot (a). Appropriate wide excision has been performed (b). A keystone flap has been created at the lateral aspect of the original excision bed (c) and then transposed medially (d) to close the defect (e). Postoperative appearance at 8 months is shown (f)

High resolution (0.7 mm3) T1-weighted MRI of patient RE. Axial slices from ventral (Top left) to dorsal (Bottom right) showing the lesion in the right dorsal midbrain and thalamus. Extension of the lesion into the rostral superior colliculus (SC) shown by white arrows.

Schematic representation of the subclonal structure and evolution of the tumor for patient PD4772. Wild-type colonies with no mutations are shown in peach and heterozygous mutations are shown in blue. No colonies with homozygous mutations were identified in this patient. Each individual cluster of colonies representing a single subclone is highlighted by a Roman numeral and the number of colonies within the subclone. (A) Row-wise representation of the mutational status of each colony for each mutation. Each row is one colony and each column is one gene. Red lines delineate clusters of colonies with the same mutational characteristics. (B) Clonal hierarchy derived from the data in (A). A node further down the hierarchy includes all mutations that precede it on the branch.

In this study we screened ATP7B gene in six members of an Iranian family with multiple affected members suspected to have WD to find the mutation which causes the illness. This study resulted in the identification of a novel combination of two mutations in ATP7B gene in affected members of this family (ClinVar Submission ID: SUB2992698).

The pedigree studied here consisted of four affected members with similar clinical features of whom only two were alive at the time of this report (Fig. 1).Fig. 1Pedigree of an Iranian family with Wilson disease. Red shading denotes affected individuals. Circles and squares with * indicate individuals who were analyzed by Sanger sequencing. The arrow in the pedigree shows the proband (the first sample in the family who was referred to us and was studied)

Pedigree of an Iranian family with Wilson disease. Red shading denotes affected individuals. Circles and squares with * indicate individuals who were analyzed by Sanger sequencing. The arrow in the pedigree shows the proband (the first sample in the family who was referred to us and was studied)

The segregation of these two variants in the family was checked by Sanger sequencing on all available samples (Figs. 2 and 3). The segregation study indicated that the c.3809A>G; p.Asn1270Ser and c.1924G>C; p.Asp642His mutations in ATP7B gene are co-segregating with the disease in this family. Affected members of the family were compound heterozygote for these mutations and each of the parents carried only one of the defective alleles.Fig. 2Genotypes of the c.3809A>G and c.1924G>C mutations in ATP7B gene in studied healthy and affected individuals of the pedigreeFig. 3Sanger sequencing traces showing the c.1924G>C; p.Asp642His mutation in exon 6 (upper row) and c.3809A>G; p.Asn1270Ser mutation in exon 18 (lower row) of the ATP7B gene. The segregation of these two mutations as compound heterozygote has been confirmed in six available DNA samples (two affected and four unaffected individuals) from this family

Sanger sequencing traces showing the c.1924G>C; p.Asp642His mutation in exon 6 (upper row) and c.3809A>G; p.Asn1270Ser mutation in exon 18 (lower row) of the ATP7B gene. The segregation of these two mutations as compound heterozygote has been confirmed in six available DNA samples (two affected and four unaffected individuals) from this family

We checked 100 healthy controls for both variants in exons 6 and 18 using ARMS method and the acquired results showed they were negative (Figs. 4 and 5).Fig. 4Picture of 2% agarose gel electrophoresis of amplification-refractory mutation system test products for exon 6 variant (c.1924G>C). Well 1: negative polymerase chain reaction test control (no template control; NTC). Well 2: normal case homozygote for GG. Well 3: IV:5 member in the family who was heterozygote for c.1924G>C (GC). Well 4–11: eight healthy members. Well 12: 100 kb ladderFig. 5Picture of 2% agarose gel electrophoresis of amplification-refractory mutation system test products for exon 18 variant (c.3809A>G). Well 1: negative polymerase chain reaction test control (no template control; NTC). Well 2: normal case homozygote for AA. Well 3: IV:5 member in the family who was heterozygote for c.3809A>G (AG). Well 4–11: eight healthy members. Well 12: 100 kb ladder

Picture of 2% agarose gel electrophoresis of amplification-refractory mutation system test products for exon 6 variant (c.1924G>C). Well 1: negative polymerase chain reaction test control (no template control; NTC). Well 2: normal case homozygote for GG. Well 3: IV:5 member in the family who was heterozygote for c.1924G>C (GC). Well 4–11: eight healthy members. Well 12: 100 kb ladder

Picture of 2% agarose gel electrophoresis of amplification-refractory mutation system test products for exon 18 variant (c.3809A>G). Well 1: negative polymerase chain reaction test control (no template control; NTC). Well 2: normal case homozygote for AA. Well 3: IV:5 member in the family who was heterozygote for c.3809A>G (AG). Well 4–11: eight healthy members. Well 12: 100 kb ladder

In this study we examined mutations in the coding regions of the ATP7B gene in an Iranian family which resulted in the identification of two mutations. A cohort of 100 ethnicity-matched healthy controls turned out to be negative for these two mutations as well as the 1000 Genomes and ExAC databases.

(A) Baseline fused 99mTc-EC-DG SPECT-CT image shows a partially cystic left level 1 lymph node with elevated radiotracer uptake peripherally (arrow). (B) Follow-up fused 99mTc-EC-DG SPECT-CT image shows decrease in size of the left level 1 lymph node but increased radiotracer uptake in the lymph node (arrow).

A. GC with metastasis in mesentery of the small intestine in a 60-year-old male patient. B. GC with metastasis in mesentery of the small intestine and colon in a 44-year-old male patient. C. GC with metastasis in mesentery of the small intestine in a 70-year-old male patient. D. GC with metastasis in abdominal wall and mesentery of the small intestine in a 63-year-old male patient. E. Colon cancer with metastasis in mesocolon in a 42-year-old female patient. F. Colon cancer with metastasis in mesentery of the small intestine in a 58-year-old female patient. G. Colon cancer with metastasis in abdominal wall and mesentery of the small intestine in a 80-year-old male patient. H. GC with metastasis in mesentery of the small intestine in a 62-year-old male patient.

A. Pathological finding of metastatic lesion by hematoxylin and eosin staining: poorly differentiated adenocarcinoma originating from stomach infiltrated the submucosa of the small intestine in this case. B. Invasive neoplastci foci were seen in the vascular wall.

A 57-year-old Chinese male presented to the Emergency Department (ED) of a tertiary hospital with complaints of transient left upper and lower limb weakness associated with a left facial droop and slurring of speech that had lasted for half an hour. He denied any history of similar events. He had a known history of human immunodeficiency virus (HIV) infection on highly active antiretroviral therapy (HAART) for the past four years. He was a nonsmoker. There was no family history of stroke.

He received a diagnosis of ischemic stroke secondary to neurosyphilitic vasculitis. The infectious diseases team was consulted and he was started on intravenous benzylpenicillin 4 million units 4 hourly for a total of 14 days. His aspirin and atorvastatin were discontinued. He recovered without any neurological sequelae during the course of his admission.

A 97-year-old man presented to the emergency department at our hospital with symptom of right hip pain following a mechanical fall. He had a below-knee amputation on his right leg following a traffic accident as a 19-year-old and had a below-knee patellar tendon bearing prosthesis fitted to his lower limb for mobility. He could walk using a T-cane with the prosthesis. Radiographs and computed tomography of his pelvis revealed a displaced intertrochanteric fracture of the right side femur (AO classification: 31-A1) (Figure 1). Internal fixation of the fracture using an intramedullary device was planned and the patient provided informed consent.

She had no past medical history and did not take any medication. She lived in a rural area in Switzerland and used to eat wild forest fruits and mushrooms. She owned cats that used to hunt rodents. She had no known underlying immunosuppression and declared no risk factors for human immunodeficiency virus (HIV) infection.

There are only limited evidence on effective alternatives for treatment of MRSA-PVE. Our case illustrates that linezolid can be considered as an option for vancomycin resistance in treating patients with MRSA-PVE and may negate the need for a valve surgery. These evidence warrant further extensive investigation on this therapeutic approach towards a successful combat against MRSA-PVE.

Correct diagnosis of T staging in a patient with well differentiated gastric cancer. (A) Endoscopic image of the gastric cancer showing an ulcer located in the anterior wall of the antrum; (B) EUS image of the lesion showing a 13-mm thick hypoechoic lesion spreading from the mucosal to muscularis propria layers with an intact serosa layer (dotted line). Surgical resection confirmed well differentiated gastric cancer infiltrated to the muscularis propria layer.

Incorrect diagnosis of T staging in a case of poorly differentiated and partial signet ring cell gastric cancer. (A) Endoscopic image of the lesion showing an ulcer lesion located in the gastric antrum; (B) EUS image of the lesion showing a 17-mm thick hypoechoic lesion that spreads throughout the entire wall and invades the serosa invasion (dotted line). The corresponding surgical specimen confirmed poorly differentiated and partial signet ring cell gastric cancer confined to the submucosal layer.

Figure 2:Radiographic findings of the lower limbs. (A and B) Male patient with osteogenesis imperfecta type 1 showing minor bowing of the right femur and diaphyseal fracture of the left femur; (C) female patient with osteogenesis imperfecta type 3 showing severe bowing of the long bones; (D) male patient with osteogenesis imperfecta type 3 showing significant diaphyseal fracture and osteoporosis.

Sequencing of the MMACHC gene in blood DNA of WG-4152 identified a previously described heterozygous c.158T>C (p.Leu53Pro) mutation9. Sequencing of bisulfite-converted DNA identified the same mono-allelic epimutation found in CHU-12122 and WG-3838. The patient was compound heterozygous for the c.158T>C mutation and the MMACHC epimutation. The c.-302G allele of rs3748643 was detected in the allele bearing the epimutation and the c.-302T allele in the non-methylated allele.

Echocardiography performed in April 2015 at a tertiary hospital in Seoul showed borderline pulmonary artery hypertension (PASP 37 mmHg). Hand perfusion scintigraphy performed by the nuclear medicine department in our hospital showed a marked decrease in perfusion and blood pooling of the chilled finger to 22% of the ambient hand finger.

Thoracoscopic findings of multiple lung cysts in two representative patients of Birt-Hogg-Dubé syndrome: a shows a thoracoscopic finding of the unique distribution of multiple lung cysts adjacent to the pericardium and the interlobar region (white arrows in a representative case). b is a thoracoscopic narrow-band image emphasizing a protuberant bulla (white arrowhead) and multiple flat cysts around interlobular septa (black arrowheads in a representative case)

A 15‐year‐old male patient (III‐1) from Shanghai visited the department of pedodontics of the Affiliated Stomatology Hospital of Tongji University with a chief complaint of pain in the right posterior mandibular region. The patient's medical and family histories were inconclusive. Patients from this family have had a family history of Gardner syndrome.

The proband's father (II‐3) died due to the Gardner syndrome. He was hospitalized and subjected to surgery on several occasions. He had a discharge diagnosis of Gardner syndrome. The pathological diagnosis was moderately differentiated tubular adenocarcinoma with mucinous adenocarcinoma (Fig. 1C).

Adenomatous polyposis coli (APC) gene structure and partial DNA sequences of exon 15 of the APC gene from the proband's family. (A) APC gene structure; (B) The arrow indicates the position of the APC heterozygous mutation 4292‐4293‐Del GA associated with supernumerary teeth in Gardner syndrome patients.

Persistent post-surgical pain was evaluated 6 month after surgery using the following criteria : the pain should be of at least 2 months’ duration; other causes for the pain should be excluded; and the possibility that the pain is a continuation of a pre-existing problem should be explored and exclusion attempted.

Pancharoen et al. reported that primary dengue infection was associated with significantly lower neutrophil count than secondary infection . This may partly explain why our case presented such severe biological signs of neutropenia as she was suffering from a primary dengue infection.

a The appearance of the hands of the female sibling showing the camptodactyly (flexion contractures) of the right middle/ring fingers and of the left ring finger. Also note the faint/absent distal flexion creases of multiple fingers. b Demonstration of the hyper-extension of the interphalangeal joint of the thumb and the flexion contracture of the middle and ring fingers. c Demonstration of hyper-extension of the index finger

Specific autoantibodies other than anti-EJ antibody were found in only one patient who had anti-SSA antibody at the initial visit and was diagnosed with Sjögren’s syndrome 20 months after the diagnosis of EJ-ILD. Other patients had neither other autoantibodies nor the diagnosis of any other collagen vascular diseases except for PM/DM.

Changes of pulmonary functions of 10 patients during whole follow up period. Four patients deteriorated with corticosteroid monotherapy. a Line graph of forced vital capacity % predicted. b Line graph of diffusing capacity of the lung for carbon monoxide % predicted

The development of foot problems appeared to follow a variable and fluctuating clinical trajectory. Participants described a range of experiences with some recalling that the first symptoms of RA were in their feet. In contrast other participants described the evolvement of foot problems as a more gradual insidious clinical feature that varied in severity: “The first sign something was going on was my feet. The balls of the foot were really uncomfortable when I walked......” (Patient 3)

Voluntary drive and normalized motion assistance provided by the external device form the foundation for a proprioceptive feedback loop for patients with cerebral palsy. HAL intervention produces neural activity and repeated execution of specific tasks. The HAL intervention promotes learning and leads to a state of appropriate proprioceptive feedback. We were able to carry out the HAL intervention for cerebral palsy in a postoperative patient safely and effectively.

The patient was treated with ceftriaxone although culture was negative. There were no surgical or postoperative complications. The hospital stay was 3 days. Nasal irrigation with isotonic saline solution every 4 hours was indicated in the first 3 months. He underwent successful revision surgeries monthly during the first 6 months before surgery without nasal synechiae or other complications. He presented a complete improvement of the algic picture and postoperative CT scans showed an air-filled cavity replacing the lesion in the sphenoid body with no residual soft-tissue lesion (Figure 5). Histopathological analysis of the solid specimen confirms presence of inflammatory tissue and calcification.. He underwent 1-year postoperative follow-up.

Intraoperative photographs of the surgical removal of the meningeal cyst in Case 1. Dorsal laminectomy at L6–L7 revealed a spinal cyst (a). The cyst was released from the cauda equina caudally (b) and retracted cranially (c) before being removed completely without collapse (d)

Medication use during treatment with omalizumab in patient 1. Red solid line Omalizumab injections; black solid line Prednisone intake; blue solid line Cetirizine intake; green solid line Ketotifen intake. Average doses of AH and oral glucocorticoids were calculated for every month in the past two and a half years

Staging Technetium 99 m‐MDP (methyl diphosphonate) bone scan was negative for bone metastasis. He was offered radical cystoprostatectomy and ileal conduit reconstruction which was abandoned due to the extensive nodal disease in the pelvis. Pelvic nodal sampling detected presence of metastases in four out of 10 nodes sampled. The patient succumbed to the disease within 9 months following diagnosis.

Ten days before hospital admission the patient had an episode of unstable angina. He underwent coronary angiography which showed a lesion in the circumflex artery and angioplasty and implantation of an intracoronary stent coated drug were performed. He started treatment with clopidogrel. By this time blood tests showed low TSH (0.055 uU/mL; reference range: 0.55–4.78 uU/mL) and high FT4 (1.81 ng/dL; reference range: 0.80–1.76 ng/dL) and FT3 (4.84 pg/mL; reference range: 2.3–4.2 pg/mL). Methimazole was started. There was no evidence of pleural effusion at that time.

“…looking at the fact that it is a degenerative neurological condition. She may have improved slightly but her ill [illness trajectory] is down. And this will have huge impacts. So it might be that temporarily she will be a little better at home. The reality is she will deteriorate. Who’s monitoring that level of deterioration and what is the point at which she needs long term care?”

We report a patient with acute emphysematous cholecystitis as the presenting feature of a recurrent melanoma metastatic to the gallbladder. This exceptional association underscores the need to consider relapse of malignancy when evaluating unexplained abdominal complaints in any patient with a known history of melanoma.

Estimation of the effective dose of a 5-year-old child during a PA chest x-ray (equivalent units). a) AP pelvic radiograph (10 CXR-equivalent units); b) abdominal ultrasound (No ionizing radiation); c) abdomen and pelvic CT (1300 CXR-equivalent units); d) head CT (Pre- and Post- contrast) (1100 CXR-equivalent units); e) neck/chest/abdomen/pelvic CT (1700 CXR-equivalent units); f) head MRI (no ionizing radiation)

Conclusion: HHP is recently recognized as a complication of RYGB although knowledge and experience with this condition are not well diffused. MMTT should be considered when there is a clinical suspicion. Informed consent to publish had been obtained from the patient (Fig. 1) Fig. 1See text for description .

Final comments: The experience presented shows that the diagnosis of DEND Syndrome should be considered even in centers with difficult access to genetic tests. Consent to publish Informed consent to publish has been obtained from this patient (her guardians).

Comprehensive ultrasound was done by the radiologist showed ileo-colic intussusception with marked thickening of the bowel wall. Vascularity was not demonstrated on the Doppler and an echogenic foci of intramural air was also noted. A trial of pneumatic reduction was attempted which was unsuccessful. The patient then underwent laparotomy which revealed ischemic terminal ileum and caecum. A right hemicolectomy with reduction of intussusception and anastomosis of bowel was done. Histopathological evaluation revealed edematous and dusky bowel in the resected specimen. Post-operative period was uneventful and he was discharged after 5 days.

Retinal images of a T1D patient with poor glycemic control and a T1D patient with good glycemic control. Comparison of retinal arteriolar caliber and retinal arteriolar branching angle between patient with poor glycemic control (a) and patient with good glycemic control (b). Blue arrows are pointing to the width of retinal arterioles while red angles are indicating retinal arteriolar branching angle. The patient with poor glycemic control had a wider average retinal arteriolar caliber (147.8 vs. 112.3 μm) and a larger average retinal arteriolar branching angle (110.4 vs. 90.0°) than the patient with good glycemic control

Typical of HALs in patients with acute large vessel occlusion in anterior circulation (Figure 2). CASE-1 demonstrates extravasation of only iodine (1A–E): A patient with right M1-segment occlusion and successfully recanalized. The highest CT value was 89 HU on immediate CT and HALs vanished on follow-up CT. CASE-2 shows IH after thrombectomy (2A–E): a patient with right proximal internal carotid artery occlusion that was reperfusion after endovascular treatment. The immediate CT shows a large amount of HALs in the right hemisphere and the highest CT value in the HALs territory was 413 HU. Follow-up CT shows hemorrhage in the right cerebral hemisphere on the 3 days. CASE-3 shows minor IH after thrombectomy (3A–E): a patient with distal occlusion of the internal carotid artery and successfully recanalized. The immediate CT shows HALs in the left ganglia with the highest CT value was 362 HU and the IH showed in the follow-up CT was examined at 24 h.

The history of her illness dated back to 1 month before her admission with the onset of generalized asthenia associated with a weight loss of 2 kg over 1 month evolving in a context of feverish sensation. Probabilistic antibiotics were prescribed without clinical improvement. The evolution was marked by the installation 1 week before his admission of an intense pain in the left eye associated with a fall of the visual acuity and a palpebral tumefaction without notion of surgery or ocular traumatism.

Figure 1 shows an example of FWHM measurement in a patient with known pulmonary hypertension. The conventional parameters were measured on the axial images of the diagnostic scans. Diameter of the MPA on cross-sectional imaging was measured at a right angle to its long axis in the scan plane of the pulmonary artery bifurcation where the right main pulmonary artery is visualized in its extent (Figure 2).

Case 1 represents a fast recovery group patient who recovered early and did not have other symptoms. The length of time until recovery of smell and taste was 9 days. This patient was not tested for COVID-19. The dates shown in Textbox 1 were added when they were recorded in Excel.

Both the anterior approach and posterior fusion were performed under general anesthesia. The patient was supine for the anterior approach. We utilized a vascular surgeon to gain retroperitoneal access to the anterior spine. A bent spinal needle was placed into the L4/5 and L5/S1 intervertebral disc space and fluoroscopy was utilized to ensure the placement was midline and at the correct lumbar level. The spinal needle was removed and the midline was marked at L4/5 and L5/S1.

We then obtained an intraoperative O-arm stealth CT to evaluate screw placement accuracy. This demonstrated a right L5 medial pedicle wall breach. The right L5 screw was then subsequently removed and not replaced. The rods were secured to the pedicle screw heads utilizing set screws. The wound was washed with saline irrigation and 1g of Vancomycin powder. The Schanz pin was removed and the wound was closed with monocryl suture.

The inclusion criteria were as follows: (1) preoperative clinical examination diagnosed as odontogenic cyst of maxilla; (2) the preoperative otolaryngologist diagnosed unilateral maxillary sinusitis; (3) preoperative CT showed the cyst extending into the sinus with complete obliteration of the maxillary sinus; (4) the cyst was found to be adhered to the mucosa of the maxillary sinus during operation; (5) histopathological examination confirmed the diagnosis of OC postoperatively.

SARS-CoV-2 infection in an Italian pet cat. The thoracic radiographs revealed the presence of pneumonia. The opaque region in the radiograph over the lung area represents the ROI (Region of Interest). The widespread presence of pathological infiltrate resulted in an unstructured interstitial pattern. Reproduced from Musso et al. (2020) under Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/.).

This report describes an unusual presentation of aHUS with skeletal muscle involvement (confirmed by biopsy-proven TMA) and additionally highlights how individualizing eculizumab dosing via pharmacokinetic modeling can be utilized to improve clinical outcomes and promote cost savings over time in patients diagnosed with aHUS.